Publications by authors named "Jose L Lazaro-Martinez"

Background: A cross-sectional study was conducted to investigate the prevalence of onychomycosis (ONM) and its causative pathogens in populations with and without diabetes in Spain. The association between the presence of ONM, different risk factors, and comorbidities was also examined.

Methodology: A total of 160 patients with diabetes and 160 individuals without diabetes were recruited consecutively.

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The aim of this study was to identify and analyze the incidence rate of amputations and their risk factors in people with Diabetes Mellitus (DM) in two specialized outpatient clinics in Brazil. This is an epidemiological, retrospective cohort study using data collected from electronic health records of 281 adult diabetic patient types 1 or 2; attended in specialized outpatient service between 2015 and 2020. Statistical analyses were performed using the 2 sample t-test or Wilcoxon-Mann-Whitney test, for quantitative variables, and the Pearson's χ2 test or Fisher's exact test for categorical variables.

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Article Synopsis
  • Caring for hard-to-heal wounds requires understanding both medical and personal factors that affect each patient's condition.
  • Wound care providers must consider comorbidities, psychosocial challenges, and individual experiences related to pain, odor, and drainage to tailor effective treatment.
  • The review emphasizes collaboration among wound care professionals, researchers, and the healthcare industry to improve accountability and meet the diverse needs of patients.
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: To evaluate the clinical efficacy of combining an offloading device with a contralateral shoe lift to compensate for induced limb-length discrepancies in participants with plantar diabetes-related foot ulcers. : Between March 2021 and December 2023, 42 consecutive patients with active plantar diabetic foot ulcers (DFUs) were randomly assigned (1:1) to the treatment group (limb-length discrepancy compensation with a shoe lift in the therapeutic footwear of the contralateral limb) or a control group that did not receive limb-length discrepancy compensation. Primary outcomes included the 20-week wound-healing rate and wound area reduction.

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Background: Conservative treatment is the first therapeutical option for central heads metatarsalgia, a common foot condition. However, to our best knowledge, systematic review and meta-analysis of its effectiveness in terms of plantar pressure improvement have not been yet carried out. Our aim was to answer the following research question: Is bespoke or customized orthotic treatment effective for plantar pressure reduction in patients with mechanical metatarsalgia in the central metatarsal heads?

Methods: A systematic review and meta-analysis of the effectiveness of bespoke or customised orthotic treatment in terms of plantar pressure reduction beneath the central -2nd to 4th - metatarsal heads in mechanical metatarsalgia patients were carried out.

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  • The study investigates the effectiveness of a silver ion-releasing foam dressing, specifically Biatain Ag, in treating hard-to-heal wounds that often experience delayed healing due to chronic inflammation and infection.
  • A meta-analysis of data from four randomized clinical trials found that this silver dressing significantly reduced wound area and improved other outcomes like odor disappearance, exudate reduction, and pain at dressing removal after four and six weeks compared to control treatments.
  • Overall, the findings suggest that silver ion-releasing foam dressings are beneficial and well-tolerated for treating moderate-to-highly exuding wounds with delayed healing.
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  • - Reports of antimicrobial resistance have led some clinicians to use alternative wound dressings called DACC-coated dressings, claiming antimicrobial activity despite being non-medicated.
  • - A systematic review was conducted to evaluate the effectiveness of these dressings on chronic wound healing and infection control, using the GRADE framework and PICO format to structure the research.
  • - The review analyzed 748 records, ultimately including 10 relevant studies, but found the overall quality of evidence to be very low, highlighting the need for more rigorous randomized controlled trials for better clarity on DACC-coated dressings.
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  • A study looked at how often diabetic foot ulcers healed with a special type of dressing called sucrose octasulfate come back after 1 year.
  • The study had two groups: one used the special dressing, and the other used different treatments.
  • Results showed fewer people in the dressing group had their ulcers return (28%) compared to the other group (66.7%), which means the special dressing worked better at preventing the wounds from coming back.
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A plantar wart is a benign hyperplasia that appears on the feet due to the human papillomavirus (HPV). One method used for the treatment of recalcitrant plantar warts, those lasting over 2 years or persisting after at least two treatment attempts, is the cantharidin (1%), podophyllin (5%), and salicylic acid (30%) formulation, also known as the CPS formulation. Although this method is in use, there are few studies on it.

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Article Synopsis
  • - The study assessed the effectiveness of dermatoscopy in diagnosing onychomycosis by comparing it to microbiological culture and PCR results among 125 patients.
  • - Results indicated that dermatoscopy was quite accurate, identifying 76.8% of patients as positive, whereas microbiological culture and PCR alone had lower positive rates.
  • - Researchers concluded that while dermatoscopy is a useful diagnostic tool, it should be used alongside other tests for the best results in identifying onychomycosis.
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Background: There are multiple conservative treatment options for plantar warts, but none have proven to be universally effective. Nitric acid is often used empirically by podiatrists in the treatment of plantar warts. A novel medical device or topical solution of nitric-zinc complex solution (NZCS) could potentially offer an effective and safe alternative for the targeted treatment of plantar warts.

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Background/objectives: To analyze the best noninvasive tests prognosis marker in patients with diabetic foot ulcer (DFU) who underwent endovascular revascularization based on clinical outcomes, such as healing rate, time to heal, and free amputation survival after at least a six-month follow-up.

Methods: A multicentric prospective observational study was performed with 28 participants with ischemic or neuroischemic DFU who came to the participant centers and underwent endovascular revascularization between January 2022 and March 2023. Toe systolic pressure (TP), ankle systolic pressure (AP), the ankle brachial pressure index (ABPI), the toe brachial pressure index (TBPI), transcutaneous pressure of oxygen (TcPO), and skin perfusion pressure (SPP) were evaluated using PeriFlux 6000 System, Perimed, Sweden, before (Visit 0) and four weeks after revascularization (Visit 1).

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  • The study aimed to analyze the relationship between bone fractures and joint dislocations with the severity of arch collapse in patients with Charcot foot, focusing on midfoot deformities.
  • It involved a retrospective review of 28 patients with midfoot Charcot foot deformity, using radiographic measurements to assess the severity of the condition and classify the fractures and dislocations observed.
  • The findings indicated that specific dislocations (like navicular-medial cuneiform) and cuboid fragmentation significantly predicted severe midfoot collapse, highlighting a link between certain injuries and the progression of the deformity.
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Negative pressure wound therapy is currently one of the most popular treatment approaches that provide a series of benefits to facilitate healing, including increased local blood perfusion with reduced localized oedema and control of wound exudate. The porous foam dressing is a critical element in the application of this therapy and its choice is based on its ability to manage exudate. Industry standards often employ aqueous solutions devoid of proteins to assess dressing performance.

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Objective: To evaluate the cost-effectiveness of two 10% urea creams in patients with diabetic foot syndrome.

Methods: This was a prospective, longitudinal, single-center, randomized, double-blind, prospective clinical trial that evaluated the skin quality of 20 feet belonging to 10 patients with diabetic foot syndrome after the application of two 10% urea creams purchased from pharmacies and supermarkets.

Results: At follow-up, 19 (95%) of the participants' feet showed improved skin quality, irrespective of the cream applied.

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This study aims to assess the atherogenic index of plasma (AIP) diagnostic value in detecting diabetic foot osteomyelitis (DFO) among patients with diabetic foot ulcers (DFUs). A prospective cohort study was conducted on 80 patients with DFUs and suspected DFO between January 2022 and December 2023. The primary outcome measures included the diagnosis of DFO, determined by positive microbiological analysis results from bone samples and its correlation with the AIP.

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Chronic wounds remain a significant clinical challenge both for those affected and for healthcare systems. The treatment is often comprised and complex. All patients should receive wound care that is integrated into a holistic approach involving local management that addresses the underlying etiology and provides for gold standard therapy to support healing, avoid complications and be more cost effective.

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This article describes the contemporary bioengineering theory and practice of evaluating the fluid handling performance of foam-based dressings, with focus on the important and clinically relevant engineering structure-function relationships and on advanced laboratory testing methods for pre-clinical quantitative assessments of this common type of wound dressings. The effects of key wound dressing material-related and treatment-related physical factors on the absorbency and overall fluid handling of foam-based dressings are thoroughly and quantitively analysed. Discussions include exudate viscosity and temperature, action of mechanical forces and the dressing microstructure and associated interactions.

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Background: Few studies have addressed the relationship of human papillomavirus (HPV) biotypes to patient characteristics and the clinical signs, course, and response to the treatment of plantar warts.

Objective: Analyze the HPV types associated with plantar warts and their relationship with warts characteristics, patient characteristics and response to treatment.

Methods: A total of 372 patients sampled for hyperkeratosis of a plantar wart were included.

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Background: Onychomycosis (ONM) is the most prevalent nail unit pathology, and its severity and monitoring are often based on the visual judgement of clinicians.

Objective: The objective of this study is to assess the reliability of the Onychomycosis Severity Index (OSI) classification when utilized by three clinicians with varying levels of clinical experience: an experienced podiatrist (with 5 years of experience), a moderately experienced podiatrist (with 2 years of experience) and an inexperienced podiatrist (a recent graduate familiar with the OSI classification but lacking clinical experience). Additionally, we compared the severity assessments made through visual inspection with those determined using the OSI by different clinicians.

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Background: We aimed to analyze levels of knowledge and behavior regarding diabetic foot care and prevention in persons with diabetes according to the International Working Group on the Diabetic Foot (IWGDF) risk stratification system.

Methods: This descriptive study included 83 persons with diabetes at different risk levels for diabetic foot ulceration (DFU) (IWGDF risk 0-3). The previously validated Patient Interpretation of Neuropathy questionnaire was used to analyze their levels of understanding of foot complications.

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Article Synopsis
  • The study aimed to assess the expectations and usability of therapeutic footwear in individuals with diabetes at risk for foot complications.
  • Conducted across 11 specialized diabetic foot units in Spain, participants received their first prescription of therapeutic footwear between March 2022 and June 2023.
  • Results showed that 94% of participants used the prescribed footwear more than they initially expected, leading to improved walking ability and a lower rate of foot ulcers during the follow-up period.
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Chronic wounds, especially those that are hard-to-heal, constitute a serious public-health problem. Although progress has been made in the development of wound dressings for healing, there is little high-quality evidence of their efficacy, with no evidence of superiority in the use of one hydrogel over another. To evaluate the superiority of a hydrogel (EHO-85), containing Olea europaea leaf extract (OELE), over a standard hydrogel (SH), the promotion and/or improvement of healing of difficult-to-heal wounds was compared in a prospective, parallel-group multicenter, randomized, observer-blinded, controlled trial ("MACAON").

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